Warren Foust video

Exploring the “New Normal” in Ophthalmology

Countries around the world are waging their own battles with the coronavirus pandemic, using differing strategies with varying degrees of success. Currently, the United States has the highest number of cases and deaths; even so, many states have begun to relax shelter-in-place restrictions. 

So, back to normal . . . right? Well, not exactly. Lifted restrictions means that elective surgeries can resume in some places — but will the patients return? And how can ophthalmologists make them feel safe doing so?

Mr. Warren Foust, worldwide president for Johnson & Johnson Vision’s surgical business, is based in California (USA). He has also considered these questions and said the optimism of both customers and patients varies by state. “There are states that are going to open faster . . . some were hit harder than others. 

“But going back to the big question: Will the patients come? I believe they will, but I believe the safety piece is really important,” said Mr. Foust.

According to him, some of these new clinical safety measures are likely to include masks (worn by all); Plexiglass shields; social distancing in the waiting room (or having a virtual waiting room); and ensuring that everything is cleaned and disinfected properly. “We have to demonstrate safety to the patient — that is going to be really important,” added Mr. Foust.

Elective Surgeries “Eye” Their Return

Exploring the “New Normal” in Ophthalmology

Refractive and cataract procedures have ground to a halt since the pandemic began its malnevolent sojourn around the globe. However, in areas with lowered restrictions, some of these elective procedures are beginning to trickle back in.

Mr. Foust said that refractive procedures are beginning to come back earlier. He attributed this to a couple of factors. First, prior to the pandemic, many surgeons already had a backlog of patients for refractive surgery. “Many of them will still want to have the procedure,” said Mr. Foust. 

Additionally, refractive patients are younger — and likely healthier — than cataract patients, which is also the demographic more likely to feel severe impacts from COVID-19. 

“Even when they [older people] are released from their shelter-in-place restrictions, there is going to be a bit of consternation around going back,” he continued. “So, we are going to see how it goes with those patients and making sure they feel safe.”

So for now, many cataract patients are in a bit of a holding pattern . . . which of course, can amount to another backlog once things “return to normal.” Customers have told Mr. Foust that patients who were scheduled for cataract surgery in March or April are still waiting. “Assuming that a high percentage of those patients still want to have surgery, there has been a backlog created in just the last couple months — and we are likely to see all those patients come through,” he said.

Mr. Foust said that to get these patients in for surgery, certain questions must be answered first: “What is going to be the funnel for those patients to be able to be educated, triaged, scheduled for surgery, put on the schedule and come later? That is also sort of unknown. 

“The other piece — irrespective of the backlog — is how fast, from a throughput point, will the surgeons be able to take patients through the process and give them an excellent outcome,” he continued.

“Now, because of the additional measures (and rightfully so), that is going to change throughput a little bit. So, I think we are going to see how this all plays out over the course of three to six months. Then we will have a better sense of what the future looks like from a capacity standpoint,” said Mr. Foust.

Getting Back to Business

Warren Foust of Johnson & Johnson shared his thoughts.

In addition to clinics, ophthalmic industry businesses are also adapting. Employees are working from home and some meetings are proceeding virtually, although most international conferences have been cancelled or postponed. “Business as usual” has been feeling a bit unusual lately. 

Just like patient safety is the main priority for doctors, keeping employees safe is the most important thing for Johnson & Johnson Vision (dually headquartered in Jacksonville, Florida, and Santa Ana, California, USA). Of course, this (and the pandemic) means that past ways of launching a product, for example, are moot. 

“In order to launch a product, historically, it required having individual conversations, having professional education discussions, etc. Typically, these things happen at an in-person congress such as ASCRS, where we had plans to launch some products,” said Mr. Foust. He said that although these things are off the table now, it doesn’t mean that products can’t be launched as intended. 

“Along with the safety of our people, having the right empathy for our customers is also very important,” he continued. “We would much rather try to understand how we can partner today and prop up ophthalmology. Then we can come together and help patients as we go forward — that is really the focus for us, and I want to make sure that our customers hear that.” 

Education also remains a key focus. Mr. Foust said that Johnson & Johnson Vision currently has products in various regulatory stages and that the company is still building information to educate both consumers and customers. “Then in due time, we will have the appropriate conversations, although we are always available to answer questions,” he added.

Living in a Virtual World

Exploring the “New Normal” in Ophthalmology

Fortunately, not all of this year’s scheduled conferences have been delayed by the virus. The American Society of Cataract and Refractive Surgeons (ASCRS 2020) is the first to go virtual, allowing both the science and business of the industry to continue — albeit with some big differences.

‘It went from thousands of square-feet down to a 15×7-inch screen,” noted Mr. Foust. “We are in unprecedented times . . . it is going to be different, it is going to be weird in some ways — and awesome in others — and we are going to be supportive.

“We are going to be there to answer questions, we are going to be there to interact, and we are going to see where it goes,” continued Mr. Foust. “I believe even when things will get back to normal, there will still be a virtual component.”

As time goes on, it’s expected that these virtual technologies and platforms — which we’ve grown accustomed to in these last few months — will improve, allowing for greater opportunities to share knowledge and continue education.

“I feel like digital education, webinars and virtual portions of meetings, have not been very well adopted [in the past] for a few reasons. At this phase, the world is scrambling around Zoom, WebEx, Skype, and different ways to do these things, and you are going to see a proliferation of those technologies,” said Mr. Foust. 

“I believe that as that happens, we are going to have better technology to deliver content .  . . and we’re going to see it balance out as we go forward in the future,” he concluded.

Editor’s Note: This story is part of the new “Q&A from Quarantine” series of CAKE Talks, where Matt Young (CEO of Media MICE and Publisher of PIE and CAKE magazines), during the time of COVID-19 lockdown, reached out to KOLs and industry friends to evaluate and discuss the impact of this pandemic to the ophthalmic world.

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